Happy New Year! As I begin my term as NAHQ president, I am proud to serve with such a dedicated board of directors. I am also proud to say that, since 2014, I’ve turned to NAHQ as my professional home both as a member and a Certified Professional in Healthcare Quality® (CPHQ). NAHQ’s professional development opportunities have been instrumental in my quality and safety career for some time. And in the past few years, NAHQ’s service has gone beyond me as an individual by expanding to serve my organization, Lifespan.
NAHQ understands the world we live in as healthcare quality professionals, and it understands the challenges we face within our healthcare organizations. NAHQ strives to stay ahead of the curve, not taking the eye off the prize: delivering higher quality, more efficient and more compassionate care for all. At NAHQ, we believe the healthcare quality and safety workforce is the biggest asset for achieving this goal.
As we enter the New Year, I am thinking about how healthcare quality and safety leaders can impact patient care through cost avoidance, which are the actions our workforce can take that avoid having to incur costs in the future. The best care is delivered in a timely and efficient manner and provides optimal outcomes. It is also the least expensive.
For example, in 2019, California state leaders, healthcare organizations, and business groups reported $345 million in cost avoidance when they implemented a CMS-funded clinical practice initiative. Where did they see the most value? The initiative resulted in 67,000 avoided emergency room visits; 57,000 avoided hospitalizations; and 750,000 patients with improved health outcomes, including 26,000 diabetics improving HbA1c control, or benefited from improved processes of care such as treatment with enhanced clinical guidelines. ¹
Lowering potential increased expenses reduces future costs. Cost avoidance is not about avoiding costs or cost savings; it’s about the money that gets left on the table and could have been reinvested into patient care. In California, realizing the $345 million in cost avoidance required $52 million in federal funding to three practice transformation networks over a four-year period. The primary goals of the federal initiative were to increase the value of healthcare through improved quality and reduced costs across the country.
We understand how vital it is to eliminate additional costs that are related to providing poor quality care. Payers won’t pay for the mistakes made and our organizations are penalized while eating the costs of longer hospital stays. A December 2022 American Hospital Association report emphasized the impact when hospitals do not receive reimbursement for the costs associated with caring for these patients for the additional days they are in the hospital. “These costs are further straining hospitals across the country that are already dealing with a range of financial pressures from historic levels of inflation to skyrocketing costs, as well as their own workforce challenges.” ²
Again, the workforce, is where we see challenges – and opportunities. As in the California example, getting to a place where we eliminate additional costs that are related to providing poor quality care requires temporary additional costs incurred to upskill the workforce. I encourage healthcare quality leaders to make this effort a priority in the New Year by creating a workforce development program that supports competency and skill development of your quality staff. Engage in their continued professional development and fund it.
NAHQ has the organizational workforce solutions to help you reach and exceed these goals. Working together, we can advance quality to new heights. Join us and let’s get started!
Nidia Williams, PhD, MBB, CPHQ, FNAHQ
¹California Achieves $345M in Cost Avoidance Through Federal Clinical Practice Initiative | HealthLeaders Media
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